| NPI | 1902905722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 60636) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 06998) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2025-03-03 |